<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receipt')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receipt" data-rule="required" class="form-control" name="row[receipt]" type="text" value="{$row.receipt}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receipt_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receipt_number" data-rule="required" class="form-control" name="row[receipt_number]" type="text" value="{$row.receipt_number}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-date" data-rule="required" class="form-control" name="row[date]" type="text" value="{$row.date}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Factory')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-factory" data-rule="required" class="form-control" name="row[factory]" type="text" value="{$row.factory}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receipt_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receipt_name" data-rule="required" class="form-control" name="row[receipt_name]" type="text" value="{$row.receipt_name}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Factory_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-factory_name" data-rule="required" class="form-control" name="row[factory_name]" type="text" value="{$row.factory_name}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Supplier')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-supplier" data-rule="required" class="form-control" name="row[supplier]" type="text" value="{$row.supplier}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Supplier_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-supplier_name" data-rule="required" class="form-control" name="row[supplier_name]" type="text" value="{$row.supplier_name}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-note" data-rule="required" class="form-control" name="row[note]" type="text" value="{$row.note}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Create_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-create_time" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[create_time]" type="text" value="{$row.create_time|datetime}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Update_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-update_time" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[update_time]" type="text" value="{$row.update_time|datetime}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
